Ultra-high-risk subgroup of children at familial risk for bipolar disorder identified

2018 ◽  
Vol 21 (1) ◽  
pp. 4-5
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Familial Risk ◽  
Ultra High Risk

scholarly journals The developmental trajectory of bipolar disorder

2014 ◽  
Vol 204 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Anne Duffy ◽  
Julie Horrocks ◽  
Sarah Doucette ◽  
Charles Keown-Stoneman ◽  
Shannon McCloskey ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Psychotic Disorders ◽  
Familial Risk ◽  
Childhood Anxiety ◽  
Developmental Trajectory ◽  
Developmental Approach ◽  
Increased Risk ◽  
Clinical Stages

BackgroundBipolar disorder is highly heritable and therefore longitudinal observation of children of affected parents is important to mapping the early natural history.AimsTo model the developmental trajectory of bipolar disorder based on the latest findings from an ongoing prospective study of the offspring of parents with well-characterised bipolar disorder.MethodA total of 229 offspring from families in which 1 parent had confirmed bipolar disorder and 86 control offspring were prospectively studied for up to 16 years. High-risk offspring were divided into subgroups based on the parental long-term response to lithium. Offspring were clinically assessed and DSM-IV diagnoses determined on masked consensus review using best estimate procedure. Adjusted survival analysis and generalised estimating equations were used to calculate differences in lifetime psychopathology. Multistate models were used to examine the progression through proposed clinical stages.ResultsHigh-risk offspring had an increased lifetime risk of a broad spectrum of disorders including bipolar disorder (hazard ratio (HR) = 20.89; P = 0.04), major depressive disorder (HR = 17.16; P = 0.004), anxiety (HR = 2.20; P = 0.03), sleep (HR = 28.21; P = 0.02) and substance use disorders (HR = 2.60; P = 0.05) compared with controls. However, only offspring from lithium non-responsive parents developed psychotic disorders. Childhood anxiety disorder predicted an increased risk of major mood disorder and evidence supported a progressive transition through clinical stages, from non-specific psychopathology to depressive and then manic or psychotic episodes.ConclusionsFindings underscore the importance of a developmental approach in conjunction with an appreciation of familial risk to facilitate earlier accurate diagnosis in symptomatic youth.

The Neural Basis of Familial Risk and Temperamental Variation in Individuals at High Risk of Bipolar Disorder

2011 ◽  
Vol 70 (4) ◽  
pp. 343-349 ◽  
Author(s):  
Heather C. Whalley ◽  
Jessika E. Sussmann ◽  
Goultchira Chakirova ◽  
Prerona Mukerjee ◽  
Anna Peel ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Familial Risk ◽  
Neural Basis

scholarly journals The association between self-reported and clinically determined hypomanic symptoms and the onset of major mood disorders

BJPsych Open ◽  
2017 ◽  
Vol 3 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Sarah Margaret Goodday ◽  
Martin Preisig ◽  
Mehdi Gholamrezaee ◽  
Paul Grof ◽  
Jules Angst ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Major Depression ◽  
Young People ◽  
Mood Disorders ◽  
Clinical Interviews ◽  
Increased Risk ◽  
Ultra High Risk ◽  
Clinically Significant ◽  
And Control

BackgroundHypomanic symptoms may be a useful predictor of mood disorder among young people at high risk for bipolar disorder.AimsTo determine whether hypomanic symptoms differentiate offspring of parents with bipolar disorder (high risk) and offspring of well parents (control) and predict the development of mood episodes.MethodHigh-risk and control offspring were prospectively assessed using semi-structured clinical interviews annually and completed the Hypomania Checklist-32 Revised (HCL-32). Clinically significant sub-threshold hypomanic symptoms (CSHS) were coded.ResultsHCL-32 total and active or elated scores were higher in control compared with high-risk offspring, whereas 14% of high-risk and 0% of control offspring had CSHS. High-risk offspring with CSHS had a fivefold increased risk of developing recurrent major depression (P=0.0002). The median onset of CSHS in high-risk offspring was 16.4 (6–31) years and was before the onset of major mood episodes.ConclusionsCSHS are precursors to major mood episodes in high-risk offspring and could identify individuals at ultra-high risk for developing bipolar disorder.

scholarly journals A Multi-Dimensional and Integrative Approach to Examining the High-Risk and Ultra-High-Risk Stages of Bipolar Disorder

EBioMedicine ◽  
2015 ◽  
Vol 2 (8) ◽  
pp. 919-928 ◽  
Author(s):  
Kangguang Lin ◽  
Guiyun Xu ◽  
Nichol M.L. Wong ◽  
Huawang Wu ◽  
Ting Li ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Integrative Approach ◽  
Ultra High Risk

At-risk studies and clinical antecedents of psychosis, bipolar disorder and depression: a scoping review in the context of clinical staging

2018 ◽  
Vol 49 (2) ◽  
pp. 177-189 ◽  
Author(s):  
Jessica A Hartmann ◽  
Barnaby Nelson ◽  
Aswin Ratheesh ◽  
Devi Treen ◽  
Patrick D McGorry
Keyword(s):  
At Risk ◽  
Bipolar Disorder ◽  
Mental Illness ◽  
High Risk ◽  
Scoping Review ◽  
Mental States ◽  
The Body ◽  
Clinical Staging ◽  
Ultra High Risk ◽  
Staging Model

AbstractIdentifying young people at risk of developing serious mental illness and identifying predictors of onset of illness has been a focus of psychiatric prediction research, particularly in the field of psychosis. Work in this area has facilitated the adoption of the clinical staging model of early clinical phenotypes, ranging from at-risk mental states to chronic and severe mental illness. It has been a topic of debate if these staging models should be conceptualised as disorder-specific or transdiagnostic. In order to inform this debate and facilitate cross-diagnostic discourse, the present scoping review provides a broad overview of the body of literature of (a) longitudinal at-risk approaches and (b) identified antecedents of (homotypic) illness progression across three major mental disorders [psychosis, bipolar disorder (BD) and depression], and places these in the context of clinical staging. Stage 0 at-risk conceptualisations (i.e. familial high-risk approaches) were identified in all three disorders. However, formalised stage 1b conceptualisations (i.e. ultra-high-risk approaches) were only present in psychosis and marginally in BD. The presence of non-specific and overlapping antecedents in the three disorders may support a general staging model, at least in the early stages of severe psychotic or mood disorders.

scholarly journals Adolescents with or at ultra-high risk for bipolar disorder exhibit erythrocyte docosahexaenoic acid and eicosapentaenoic acid deficits: a candidate prodromal risk biomarker

2015 ◽  
Vol 10 (3) ◽  
pp. 203-211 ◽  
Author(s):  
Robert K. McNamara ◽  
Ronald Jandacek ◽  
Patrick Tso ◽  
Thomas J. Blom ◽  
Jeffrey A. Welge ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Docosahexaenoic Acid ◽  
Eicosapentaenoic Acid ◽  
Ultra High Risk

Adverse effects of obesity on cognitive functions in individuals at ultra high risk for bipolar disorder: Results from the global mood and brain science initiative

2017 ◽  
Vol 19 (2) ◽  
pp. 128-134 ◽  
Author(s):  
Roger S. McIntyre ◽  
Rodrigo B. Mansur ◽  
Yena Lee ◽  
Letícia Japiassú ◽  
Kun Chen ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Adverse Effects ◽  
Cognitive Functions ◽  
Brain Science ◽  
Ultra High Risk ◽  
Science Initiative

Disruptive mood dysregulation disorder, severe mood dysregulation and chronic irritability in youth at high familial risk of bipolar disorder

2016 ◽  
Vol 51 (12) ◽  
pp. 1220-1226 ◽  
Author(s):  
Tania Perich ◽  
Andrew Frankland ◽  
Gloria Roberts ◽  
Florence Levy ◽  
Rhoshel Lenroot ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Familial Risk ◽  
Australian Study ◽  
Statistical Manual ◽  
Diagnostic And Statistical Manual ◽  
Disruptive Mood Dysregulation Disorder ◽  
Severe Mood Dysregulation ◽  
Irritable Mood ◽  
Mood Dysregulation

Objective: Disruptive mood dysregulation disorder is a newly proposed childhood disorder included in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition to describe children ⩽18 years of age with chronic irritability/temper outbursts. This study aimed to examine the prevalence of disruptive mood dysregulation disorder, severe mood dysregulation and chronic irritability in an Australian study of young people at increased familial risk of developing bipolar disorder (‘HR’ group) and controls (‘CON’ group). Methods: A total of 242 12- to 30-year-old HR or CON subjects were administered the severe mood dysregulation module. Of these, 42 were aged ⩽18 years at the time of assessment, with 29 subjects in the HR group and 13 in the CON group. Results: No subjects ⩽18 years – in either group – fulfilled current or lifetime criteria for disruptive mood dysregulation disorder or severe mood dysregulation, the precursor to disruptive mood dysregulation disorder. Similarly, no subjects in either group endorsed the severe mood dysregulation/disruptive mood dysregulation disorder criteria for irritable mood or marked excessive reactivity. One HR participant endorsed three severe mood dysregulation criteria (distractibility, physical restlessness and intrusiveness), while none of the comparison subjects endorsed any criteria. Exploratory studies of the broader 12- to 30-year-old sample similarly found no subjects with severe mood dysregulation/disruptive mood dysregulation disorder in either the HR or CON group and no increased rates of chronic irritability, although significantly more HR subjects reported at least one severe mood dysregulation/disruptive mood dysregulation disorder criterion (likelihood ratio = 6.17; p = 0.013); most of the reported criteria were severe mood dysregulation ‘chronic hyper-arousal’ symptoms. Conclusion: This study comprises one of the few non-US reports on the prevalence of disruptive mood dysregulation disorder and severe mood dysregulation and is the first non-US study of the prevalence of these conditions in a high-risk bipolar disorder sample. The failure to replicate the finding of higher rates of disruptive mood dysregulation disorder and chronic irritability in high-risk offspring suggests that these are not robust precursors of bipolar disorder.

scholarly journals Investigating the association between anxiety symptoms and mood disorder in high-risk offspring of bipolar parents: a comparison of Joint and Cox models

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Ruoxi Dong ◽  
George Stefan ◽  
Julie Horrocks ◽  
Sarah M. Goodday ◽  
Anne Duffy
Keyword(s):  
Bipolar Disorder ◽  
High Risk ◽  
Mood Disorder ◽  
Cox Model ◽  
Familial Risk ◽  
Clinical Information ◽  
Statistical Modelling ◽  
Joint Model ◽  
Anxiety Symptoms ◽  
Cox Models

Abstract Background Anxiety is associated with mood disorders including bipolar disorder. Two statistical modelling frameworks were compared to investigate the longitudinal relationship between repeatedly measured anxiety symptoms and the onset of depression and bipolar disorder in youth at confirmed familial risk. Methods Prospectively collected data on 156 offspring of a parent with confirmed bipolar disorder participating in the Canadian Flourish high-risk offspring longitudinal cohort study were used for this analysis. As part of the research protocol at approximately yearly visits, a research psychiatrist completed the HAM-A and a semi-structured diagnostic research interview following KSADS-PL format. Diagnoses using DSM-IV criteria were made on blind consensus review of all available clinical information. We investigated two statistical approaches, Cox model and Joint model, to evaluate the relationship between repeated HAM-A scores and the onset of major depressive or bipolar disorder. The Joint model estimates the trajectory of the longitudinal variable using a longitudinal sub-model and incorporates this estimated trajectory into a Cox sub-model. Results There was evidence of an increased hazard of major mood disorder for high-risk individuals with higher HAM-A scores under both modelling frameworks. After adjusting for other covariates, a one-unit increase in log-transformed HAM-A score was associated with a hazard ratio of 1.74 (95% CI (1.12, 2.72)) in the Cox model compared to 2.91(95% CI (1.29, 6.52)) in the Joint model. In an exploratory analysis there was no evidence that family clustering substantially affected the conclusions. Conclusions Estimated effects from the conventional Cox model, which is often the model of choice, were dramatically lower in this dataset, compared to the Joint model. While the Cox model is often considered the approach of choice for analysis, research has shown that the Joint model may be more efficient and less biased. Our analysis based on a Joint model suggests that the magnitude of association between anxiety and mood disorder in individuals at familial risk of developing bipolar disorder may be stronger than previously reported.

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